Welcome to Health Care POV | sign in | join
Stepwise Success

Abort Retry Ignore

Published October 23, 2009 6:07 AM by Scott Warner

MS-DOS (Microsoft Disk Operating System) debuted 28 years ago, quickly finding its way into labs on PCs in offices or attached to instruments. Programs such as BASIC promised much. We just knew, deep down, that computers meant less paper, effortless statistics, and (ha, ha) fewer telephone calls.

Nearly three decades should be enough time for a technology that doubles in capacity every two years (Moore's law) to accomplish all this. But modern information systems generate more paper, telephone calls, and steps than our old paper system ever did. We fill a dozen recycle bins a day, generate dozens of corrected and amended reports, worry about intermittent network failures, and spend hours on the telephone arguing with "support" that something doesn't work. We tolerate a standard that is sometimes unresponsive, often inadequate, and frequently burdensome.

Don't get me wrong – it's great to get statistics, retrieve results, or send reports instantly. But let's be real. Do we really know results are stored correctly in history? Do we really know reports are sent to the correct doctor? Do we really know calculations are done correctly? All software is buggy.

Somewhere along the way we started working for these machines, which, for all their speed and memory, are painfully slow. More and more time is spent waiting for a computer to retrieve, process, or print. Patients are compared to barcodes, stickers, and wristbands. Quality control is driven by point-at-a-time rule decisions, inviting techs to repeat until in. The days of multitasking, holding a requisition in hand, and glancing at a dozen plots on a wall are gone, replaced by efficiency designed by people who are, for the most part, not laboratory professionals. I wonder when this "efficiency" will happen.

Any application needs a simple test: does it suggest a better way of doing what we do now? We don't buy potential, after all, but performance. Each laboratory needs to define what "better" means, and managers should listen to their techs. The bookends are still the doctor and the patient, and computers need to shorten the distance between the two.

2 comments

Lu -- I hear you!  I'm a huge fan of computers, but the test is do they create a better way to do something or add a layer of technology?  And, well, it depends.

An example of the latter is an information system application of Westgard rules.  It is great that a user is flagged real-time of a 12S error.  But is this "better" than a tech plotting points on a wall graph?  Let's suppose, instead, that the system not only flags the user, but checks out other levels of controls run, methods also affected by significant variables i.e. temperature and wavelength, and historical performance i.e. shifts and trends.  This is easy to program!  The computer would be "better" if it did what we do, only faster and without hunting for the information.  Instead, we are dependent on the computer to flag one outlier correctly.  And without all the information at our fingertips, we are tempted to act on this univariate data.

Scott Warner October 24, 2009 10:57 AM

Aw, c'mon Scott - don't be so negative.  Computers have made my life so much more hassle free in blood bank that I could kiss the Meditech founders.  No more hours of hunting lost FFP's.  No more wondering why I couldn't find a unit that was supposedly crossmatched and ready to give.  I loved the very first QC program I got on a little CBC machine in a tiny hospital and all the improvements have been for the most part good.  I've seen a few upgrades that were "downgrades" but over all, we've come a long way.

Lu Hubert October 23, 2009 1:59 PM
College Station TX

leave a comment



To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Captcha
Enter the security code below: